title: Effect of degeneration on gene expression of chondrogenic and inflammatory marker genes of intervertebral disc cells: a preliminary study.
abstract: OBJECTIVE
  New techniques for biological repair in the treatment of degenerative disc disease (DDD) have been developed recently. The question arises whether it is possible to find a predictive marker to identify a patient population which could benefit from this new treatment option. Standard magnetic resonance imaging (MRI) fails to differentiate between pathologic painful and asymptomatic aging discs. Neurological symptoms contribute to identifying the pathological level. In this preliminary translational research study we analysed the gene expression of structure proteins and inflammatory mediators as well as histological features of lumbar intervertebral discs in symptomatic patients with various signs of degeneration in the MRI.
  
  
  METHODS
  Specimens of intervertebral disc tissue were obtained from 20 patients undergoing lumbar nucleotomy. Preoperatively, a group selection based on four pre-defined MRI-criteria was performed: Group 1 (mild signs of degeneration), group 2 (moderate), group 3 (moderate-severe), group 4 (severe).
  
  
  RESULTS
  An increase of the expression of structural proteins and inflammatory markers could be observed in MRI-groups 2 and 3. Gene expression of collagen type I and II and aggrecan went along with levels of cyclooxygenase-2 (COX-2) and (fibroblast growth factor-2) FGF-2 expression. Histological examination showed signs of granulation tissue in only 35% of cases, but no differences between the groups.
  
  
  CONCLUSIONS
  Our findings implicate that the gene expression of structural proteins might correlate with the appearance of inflammatory mediators in symptomatic patients with moderate disc changes in the MRI in this preliminary clinical subset. The assessment of cell activity and protein expression in a larger number of patients could be next step to support and supplement the present data.
authors.affiliation: Department of Neurosurgery, Charité, Berlin Medical University, Berlin, Germany - mario.cabraja@charite.de.
authors.forename: M
authors.initials: M
authors.lastname: Cabraja
authors.forename: M
authors.initials: M
authors.lastname: Endres
authors.forename: A
authors.initials: A
authors.lastname: Abbushi
authors.forename: M
authors.initials: M
authors.lastname: Zenclussen
authors.forename: C
authors.initials: C
authors.lastname: Blechschmidt
authors.forename: A J
authors.initials: AJ
authors.lastname: Lemke
authors.forename: S
authors.initials: S
authors.lastname: Kroppenstedt
authors.forename: C
authors.initials: C
authors.lastname: Kaps
authors.forename: C
authors.initials: C
authors.lastname: Woiciechowsky
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D024042:Collagen Type I / Q000235:genetics / Q000378:metabolism; D051546:Cyclooxygenase 2 / Q000235:genetics / Q000378:metabolism; D005260:Female; D016222:Fibroblast Growth Factor 2 / Q000235:genetics / Q000378:metabolism; D015870:Gene Expression; D006801:Humans; D007403:Intervertebral Disc / Q000378:metabolism* / Q000601:surgery; D055959:Intervertebral Disc Degeneration / Q000235:genetics* / Q000378:metabolism / Q000601:surgery; D007405:Intervertebral Disc Displacement / Q000235:genetics* / Q000378:metabolism / Q000601:surgery; D008297:Male; D008875:Middle Aged
chemical_list: D015415:Biomarkers; D024042:Collagen Type I; D016222:Fibroblast Growth Factor 2; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human